An inflammatory condition that is characterized by high fevers, joint pain, and a distinctive rash, adult Still's disease is also known as adult-onset Still's disease (AOSD). This article discusses the causes, symptoms, diagnosis, treatment, and prevention of adult Still's disease.
Causes
There is no known cause for adult Still's disease, but it is thought to be an autoimmune disease in which the body's immune system mistakenly attacks its tissues, causing inflammation. The development of adult Still's disease may be triggered by viral or bacterial infections, environmental factors, or genetics.
Symptoms
The most common symptoms of adult Still's disease are systemic and joint-related.
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A persistent high fever, often exceeding 102 degrees Fahrenheit (39 degrees Celsius), occurs once or twice a day and may continue for weeks or even months.
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Painful, swollen joints, especially in the wrists, knees, ankles, and elbows. Joint symptoms may migrate from one joint to another as well as stiffness and limited range of motion.
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Fever may be accompanied by a salmon-colored rash on the trunk, arms, or legs.
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Individuals with adult Still's disease may experience a sore throat or swollen lymph nodes.
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An inflammatory process may cause profound fatigue and weakness.
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There may be generalized muscle aches and pains during febrile episodes.
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Symptoms such as swollen lymph nodes, abdominal pain, weight loss, and difficulty breathing may also occur.
Diagnosis
The variable presentation of adult Still's disease and the absence of specific diagnostic tests can make diagnosing it challenging. Symptoms of similar conditions may be diagnosed based on a combination of clinical findings and exclusion of other possible causes. Diagnostic assessments may include:
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Examine symptoms, medical history, and physical examination for signs of inflammation, joint involvement, and systemic symptoms.
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Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), as well as abnormalities in white blood cell count and liver function tests, may be detected in blood tests.
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For joint pain and swelling, X-rays, ultrasounds, or MRI scans may be performed to assess for inflammation and damage.
Treatment
Adult Still's disease is treated to relieve symptoms, control inflammation, and prevent complications. Treatment options include:
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Pain, fever, and inflammation may be reduced by nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
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To control severe inflammation and alleviate symptoms during flare-ups, corticosteroids may be prescribed orally or intravenously.
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In more severe cases, disease-modifying antirheumatic drugs (DMARDs) such as methotrexate or sulfasalazine may be used to suppress the immune system and reduce disease activity.
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In individuals with refractory disease or those who cannot tolerate other treatments, biologic medications such as tumor necrosis factor (TNF) inhibitors or interleukin-1 (IL-1) inhibitors may be prescribed.
Prevention
The exact cause of adult Still's disease is unknown, so there are currently no specific preventive measures available. It is possible, however, to alleviate symptoms and prevent complications associated with the condition if symptoms are recognized and treated promptly. Additionally, people with autoimmune diseases or recurrent fevers and joint pain should seek medical attention to rule out adult Still's disease.
